Anterior neck soft tissue thickness for airway evaluation measured by MRI in patients with cervical spondylosis: prospective cohort study

Han, Yongzheng; Fang, Jingchao; Zhang, Hua; Xu, Mao; Guo, Xiangyang

doi:10.1136/bmjopen-2019-029987

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…Findings for the above patient characteristics were shown to have very high predictive and comparative variability, with sensitivity, specificity, and significance values ranging from low to very high across all patient demographic measures (Category B2-E evidence). 6–70 No single characteristic was identified as consistently being more predictive than another, and multivariate measures intended to predict difficult airways were too few and diverse among the studies to determine a common set of predictors.…”

Section: Guidelinesmentioning

confidence: 99%

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

675

547

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The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care, Learning, Teaching and Investigation Difficult Airway Group; Society for Airway Management; Society for Ambulatory Anesthesia; Society for Head and Neck Anesthesia; Society for Pediatric Anesthesia; Society of Critical Care Anesthesiologists; and the Trauma Anesthesiology Society present an updated report of the Practice Guidelines for Management of the Difficult Airway.

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Section: Guidelinesmentioning

confidence: 99%

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

675

547

View full text Add to dashboard Cite

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“…More specifically, laryngoscopy is more difficult when the vocal cords are located more proximal to the head ( 95 ). The thickness of the anterior cervical soft tissue on MRI is not correlated with the difficult laryngoscopy ( 96 ). In patients with cervical spine trauma, the thickness of the retropharyngeal space is associated with a difficult intubation ( 97 ) (evidence level: low or very low).…”

Section: Imagingmentioning

confidence: 99%

Expert consensus on difficult airway assessment

Xia¹,

Ma²,

Zuo³

et al. 2023

Hepatobiliary Surg Nutr

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Background Identifying a potentially difficult airway is crucial both in anaesthesia in the operating room (OR) and non-operation room sites. There are no guidelines or expert consensus focused on the assessment of the difficult airway before, so this expert consensus is developed to provide guidance for airway assessment, making this process more standardized and accurate to reduce airway-related complications and improve safety. Methods Seven members from the Airway Management Group of the Chinese Society of Anaesthesiology (CSA) met to discuss the first draft and then this was sent to 15 international experts for review, comment, and approval. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) is used to determine the level of evidence and grade the strength of recommendations. The recommendations were revised through a three-round Delphi survey from experts. Results This expert consensus provides a comprehensive approach to airway assessment based on the medical history, physical examination, comprehensive scores, imaging, and new developments including transnasal endoscopy, virtual laryngoscopy, and 3D printing. In addition, this consensus also reviews some new technologies currently under development such as prediction from facial images and voice information with the aim of proposing new research directions for the assessment of difficult airway. Conclusions This consensus applies to anesthesiologists, critical care, and emergency physicians refining the preoperative airway assessment and preparing an appropriate intubation strategy for patients with a potentially difficult airway.

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“…Airway management is regarded as the most important aspect in clinical anesthesia and a successful intubation remains crucial for surgical procedures [ 1 ]. Clinically, there are many factors associated with difficulty of intubation during laryngoscopy, including head-neck trauma [ 2 ], airway abnormalities [ 3 ], gastroesophageal reflux disease [ 4 ], hard to open mouth [ 5 ], impaired cervical mobility [ 6 ], etc. The incidence of difficulty to undergo laryngoscopy and intubation ranges widely among different studies, and patients with cervical spondylosis have a higher incidence of difficult laryngoscopy (17.1%) [ 7 ] than those without cervical spondylosis (7.3%) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Radiological indicators to predict the application of assistant intubation techniques for patients undergoing cervical surgery

et al. 2020

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Background We aimed to distinguish the preoperative radiological indicators to predict the application of assistant techniques during intubation for patients undergoing selective cervical surgery. Methods A total of 104 patients were enrolled in this study. According to whether intubation was successfully accomplished by simple Macintosh laryngoscopy, patients were divided into Macintosh laryngoscopy group (n = 78) and Assistant technique group (n = 26). We measured patients’ radiographical data via their preoperative X-ray and MRI images, and compared the differences between two groups. Binary logistic regression model was applied to distinguish the meaningful predictors. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to describe the discrimination ability of indicators. The highest Youden’s index corresponded to an optimal cut-off value. Results Ten variables exhibited significant statistical differences between two groups (P < 0.05). Based on logistic regression model, four further showed correlation with the application of assistant techniques, namely, perpendicular distance from hard palate to tip of upper incisor (X2), atlanto-occipital gap (X9), angle between a line passing through posterior-superior point of hard palate and the lowest point of the occipital bone and a line passing through the anterior-inferior point and the posterior-inferior point of the second cervical vertebral body (Angle E), and distance from skin to hyoid bone (MRI 7). Angle E owned the largest AUC (0.929), and its optimal cut-off value was 19.9° (sensitivity = 88.5%, specificity = 91.0%). the optimal cut-off value, sensitivity and specificity of other three variables were X2 (30.1 mm, 76.9, 76.9%), MRI7 (16.3 mm, 69.2, 87.2%), and X9 (7.3 mm, 73.1, 56.4%). Conclusions Four radiological variables possessed potential ability to predict the application of assistant intubation techniques. Anaesthesiologists are recommended to apply assistant techniques more positively once encountering the mentioned cut-off values.

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Anterior neck soft tissue thickness for airway evaluation measured by MRI in patients with cervical spondylosis: prospective cohort study

Cited by 9 publications

References 24 publications

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

Expert consensus on difficult airway assessment

Radiological indicators to predict the application of assistant intubation techniques for patients undergoing cervical surgery

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